Department of Surgery, McMaster University, Hamilton, ON, Canada.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
Am J Surg. 2021 Aug;222(2):361-367. doi: 10.1016/j.amjsurg.2020.12.029. Epub 2020 Dec 25.
We compared disease characteristics, therapies offered and received, and outcomes between older (>75 years) and younger (60-75 years) women with breast cancer (BC) from a regional database in Ontario, Canada.
BC surgical cases from 12 hospitals were included. Younger (60-75 years) and older (>75 years) groups were compared. Cox proportional hazards regression with competing risk analyses assessed the relationship between predictor variables, 10-year recurrence and BC-specific mortality.
Our sample comprised 774 women; 33.5% were older. Older women had larger tumours, were more likely to have positive nodes, had more comorbidities, were more likely to undergo mastectomy, had less nodal surgery, were less likely to receive adjuvant therapies, and experienced more recurrences and BC-specific deaths (p < 0.05). Significant predictors of recurrence were older age, higher grade and disease stage, and omission of nodal surgery. Older age, higher grade, and stage were predictors of BC-specific mortality.
Older BC patients (>75 years) received less treatment and experienced increased recurrence and BC-specific mortality.
我们比较了加拿大安大略省一个地区数据库中年龄较大（>75 岁）和年龄较小（60-75 岁）的乳腺癌（BC）女性患者的疾病特征、提供和接受的治疗以及结局。
纳入了 12 家医院的 BC 手术病例。比较了年龄较小（60-75 岁）和年龄较大（>75 岁）组。使用竞争风险分析的 Cox 比例风险回归评估了预测变量、10 年复发和 BC 特异性死亡率之间的关系。
我们的样本包括 774 名女性；33.5%为年龄较大者。老年女性肿瘤较大，淋巴结阳性的可能性更高，合并症更多，更可能接受乳房切除术，淋巴结手术更少，辅助治疗的可能性更小，复发和 BC 特异性死亡的发生率更高（p<0.05）。复发的显著预测因素是年龄较大、肿瘤分级和疾病分期以及淋巴结手术的遗漏。年龄较大、肿瘤分级和分期是 BC 特异性死亡的预测因素。
年龄较大的 BC 患者（>75 岁）接受的治疗较少，复发和 BC 特异性死亡率增加。
